| Background and purpose The latest released Global cancer statistics show that lung cancer, breast cancer, prostate cancer and colorectal cancer are still primary causes of cancer death.Among them, lung cancer accounts for approximately 27% of cancer mortality. None-small cell lung cancer(NSCLC) is the most frequent type of lung cancer,accounted for the 85%. Because of the unspecific symptomatology of early non small cell lung cancer, 50% cases are diagnosed at an advanced stage. The deaths of cancer patients is often due to metastasis. The skeleton is the most common metastatic tissue of cancer patients in addition to the lung and liver. Bone metastases occur most commonly in patients with advanced breast, prostate, and lung cancer. The incidence rate of non-small-cell lung cancer patients with bone metastasis is 30%-40%. The axial skeleton is preferentially metastasize, including the vertebrae, pelvis, proximal ends of long bones, and skull. Radionuclide bone scanning are the most common method of diagnosis, 66% of early bone lesions can be found. The average survival time of the patients with bone metastatic tumor is 18.8 months.The prognosis of prostate or breast cancer bone metastases is the best, and the prognosis of lung cancer bone metastasis is the worst. Currently, the median survival time of bone metastasis was 6-10 months, 1- year survival rates after treatmentremain at approximately 40%-50%. However, the study of bone metastasis mainly concentrated in breast cancer and prostate cancer. We lack a comprehensive analysis of prognostic factors on non small cell lung cancer with bone metastasis.This study was to analyze the prognostic factors and survival of NSCLC patients with bone metastases, in order to evaluate the prognosis effectively and take targeted treatment measures.Datas and Methods Clinical data of 78 advanced NSCLC patients with bone metastasis were retrospectively analyzed, in the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2013. All patients were defined their pathology type and metastatic sites, including bone, lung, liver, adrenal gland, brain, lymph nodes and subcutaneous. Use telephone follow-up and outpatient follow-up, the last follow-up time was September 1, 2015.Record the date of diagnosis and the time of death or the last follow-up time.Statistical Methods Using the SPSS 17.0 software for statistical analysis. Kaplan-Meier method was used to estimate the 1- and 2-year survival rates of patients. Log-rank time series analysis for the univariate analysis was used to screen the factors influencing the survival of patients and Cox proportional hazard model for the multivariate analysis was used to further confirm the independent factors. P value of< 0.05 was considered statistically significant.Results 1.Survival situation: Of 78 patients in this group, the median overall survival was 10.5 months(95% confidence interval:8.4 months-12.6 months). The 1- and 2-year survival rates were 48.7% and 15.4%. 2.Univariate analysis: ECOG score, pathological type, metastases other thanbone, chemotherapy and molecular targeted treatment(MTT) are prognostic factors for non-small cell lung cancer patients with bone metastasis. Patients with ECOG score of 1 to 0, adenocarcinoma, simple bone metastasis, chemotherapy and molecular targeted therapy(MTT) have a much better prognosis. Age, the serum alkaline phosphatase levels at the time of initialdiagnosis and analgesic therapy are not associated with prognosis. 3.Multivariate analysis: Introduct four factors with statistical significance from the univariate analysis and use cox proportional hazards regression analysis model.The results showed that ECOG score, pathological type, other than bone metastases,chemotherapy and molecular targeted therapy were independent prognostic factors.Conclusion Non-small cell lung cancer patients with bone metastasis who were with good KPS, adenocarcinoma, merely bone metastasis, received chemotherapy and MTT had better prognosis. |
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